HomeMy WebLinkAboutS2021-0188 - Permits*0£x'rci City of Newport Beach - Building Division
- 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
r't�tiN1M
Job Address: 1720 KINGS RD Floor: Suite:
Description of Work:SFR NEW POOL & SPA 455 SF
t
Inspector Area: 3
Legal Description: N TR 1221 LOT 15
Owner: WERNER ERIC
Address: 1720 KINGS RD
NEWPORT BEACH, CA 92663
Phone:
Applicant: ELLISON PAUL
Address: 24642 VIA RAZA
LAKE FOREST, CA 92630
Phone: 949-683-9861
Building Rear:
Setbacks: Front:
Left:
Right:
Construction Tvoe
Construction Valuation: $30,000.00
Building Permit Fee : $440.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$396.00
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE: $996.00
Bldg: 1
*S2021-0188*
POOI.Permit : S2021-0188
Project No: 1888-2021
Inspection Requests Phone (949)644-3255
Plan Check No: 1888-2021
Code Edit: 2019
Contractor: PROMONTORY POOLS INC
Address:
17401 IRVINE BLVD STE B
TUSTIN CA 92780
Phone:
714-993-0554
Con State Lic:
404194
Lic Expire:
03/31/2023
Bus Lic:
BT30043247
Lic Exp Date:
05/3V2022
Worker's Compensation Insurance
Carrier: EXEMPT
Policy No: NO EMPLOYEES
Expiration:
FEES
Architect:
Address:
Phone
Engineer: LACHERTODD
Address: 1201 N TUSTIN AVE
ANAHEIM CA 92807
Phone: 714-630-6100
Special Conditions:
Issued Date: 08/17/2021
State Lic:
State Lic:C-067656'
Record Management:
$6.00
Water Quality --
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee :
$0.00
Water Quality Dept Insp Fee:
$152.00
Drainage Plan Check:
$0.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Others
$0.00
Additional Fee :
$0.00
$0.00
PROCESSED BY:
ZONING APPROVAL:
Plan Check Fee : $0.00 /(Fee Due at Permit Issuance : $996.00
PLAN CHECKED BY::
APPROVALTOISSUE: LEI✓
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500). 1201 N TUSTIN AVE
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law COPS not
apply to an owner J, Property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from licensure under the Contractors' State License Law for the following reason:
dy a,y signature oe,av I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
not' c ctmcture tF.at : `lave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Omfess�ons Ccde is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
oignd,ure of Pronerty Owner or Authorized Agent Date
' LICENSED CGfi 7. RACTOR'S DECLARATION
hel J:,y affirn, ul,uer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section_ 0) of ivisi n 3 of the Business and Pro s' ns , an my I" e e is in full force
' 3n'' ,`fact. Liren ie Class License No Date /9 Contractor Signature
ERS' COMPENSATION DECLARATION
II'•'` _,'O: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
lICOtlT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES.
I F,rrebv affirm u,Iuel pan alty of perjury one of the following declarations:
!I ' `.nve and wN mrintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN
liperformance Or •h= v'rk for which this permit is issued. Policy No.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
urance carrier and policy number are:
Policy Number
of Agent
Date
certify that, in the perfonnan the work ich thi per it
is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre
I I should become ubjec o t rke co arse on ovisions of Section 3700 of the Labor Code, I Shall forthwith comply with those provisions.
Ignatura of Applican Cat
IECLARATION REG D ON ION I ENCY
hereby affirm under penalty o perjury that there is a construction lending agency for the performance of the work for which this permit S issued (Section 3097, Civil Code).
ender's Name
ly my signature below, I certify to each of the following:
I am the property owner or authorized to act on the
I have read this application and the information I h
I agree to comply with all applicable city and c u y
I authorize representatives of this city or count e
of Property Owner or Authorized
ACTION
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
POOL ALARMS
INSTALLED
to building construction.
,rrInspection purposes.
DECLARATION OF COMPLIANCE WITH CODE OF I
FEDE
DATE BY \ REGULATIONS PA T610 TTLE 40 AN AQMD RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
EPA
FOR OFFICE USE ONLY
PERMIT FINAL
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